Scientific studies followed by clinical trials have established a strong link between diet and health. Changing lifestyle has modified dietary pattern of community at large. Consumption of junk and processed foods is the primary cause of diet-linked diseases. According to recent estimates of WHO, about 47 % of the total deaths are attributed to non-communicable diseases. Among them, cardiovascular diseases are leading cause of mortality (25%) in developing countries like Pakistan followed by cancer, arthritis and diabetes coupled with a few minor but complicated health problems like constipation. With time, the emphasis of consumer have been greatly shifted from merely satisfying hunger to the potential use of food for health promotion. The main drivers of this change are advancements in the knowledge of nutrition and rising public awareness about healthier food choices. The tenet "Let food be the medicine and medicine be the food," was coined by Hippocrates nearly 2,500 years ago. With ever increasing awareness about healthful foods, this doctrine of Hippocrates is getting more and more relevant in recent era. The use of whole grains is of paramount importance in this regard to address a number of diet related ailments effectively, economically and above all, naturally.
Cereal grains are the dietary staples worldwide as well as in Pakistan providing long term and economic availability of nearly all nutrients required for normal growth and development. The majority of these nutrients is concentrated in the outer portion of the grain, called the bran, which is lost during milling along with these valuable nutrients, including fiber, iron, zinc, vitamin B, vitamin E and certain antioxidants. Therefore, the use of whole grains is imperative to enrich our diets with these valuable components and thus utilizing the true potential of cereal grains.
Whole grains, as per definition, are “intact, ground, cracked or flaked fruit of the grain whose principal components, the starchy endosperm, germ and bran, are present in the same relative proportions as they exist in the intact grain”. To be categorized as “whole grain food” a processed and reconstituted food must deliver the same amount of germ, endosperm and bran as present in the original unprocessed grains. Commonly consumed whole grains are brown rice, oats, barley, whole corn, whole wheat, whole rye, sorghum, millet and wild rice.
Whole grains have been reported to help against various diet related ailments, including diabetes, cardiovascular disorders, obesity and weight gain, certain type of cancers, arthritis and gastrointestinal problems. Epidemiological studies have consistently proven that whole grain consumption is positively linked to decreased incidence of heart diseases. Though, dietary fiber is considered to be the key component responsible to reduce the risk of type-II diabetes and cardiovascular diseases, however, various scientific studies have proven a stronger impact of whole grain consumption on CVDs risk reduction as compared to the impact of dietary fiber alone. This indicates a synergistic impact of various bioactive components of whole grain in addressing the diet-linked ailments. A recent meta-analysis of seven studies estimated 21% reduction in risks of CVDs with increased consumption of whole grains (3 servings per day). Thus, increased and sustained consumption of whole grains is imperative to counter 25% deaths attributable to CVDs.
Diabetes is one of the most prevalent diseases in our community characterized by high blood glucose levels. According to recent estimates, Pakistan is considered to have 7th largest population of diabetics. Due to slower digestibility, whole grains are indorsed to affect blood glucose and insulin responses positively. Since whole grain bread results in a smaller rise in blood glucose levels as compared to white bread in type II diabetes patients, it is recognized as an intelligent choice. A massive study conducted on 90,000 women and 45,000 men suggested that those with higher intake of whole grains and cereal fiber had about 30% less chance to develop type II diabetes. Therefore, consumption of whole grains should be encouraged to combat the growing menace of diabetics.
Weight regulation is another important aspect in disease management. Consumption of whole grains and whole grain foods is associated with lower risks of obesity and weight gain, resultantly helpful in reducing obesity-related health issues. Less weight gain has been observed in the individuals consuming whole grains in their daily diet in several clinical trials, especially in middle-age women. Similar results have been reported for waist to hip ratio.
There are substantial scientific evidences supporting the role of whole grain against the onset of cancer. Several components of whole gains including dietary fiber, vitamin E, selenium and some anti-nutritional factors are associated with lower cancer risks through different mechanisms.
Gastrointestinal health is associated with a number of factors like age, genetics, environment, diet & lifestyle and is characterized by efficient digestion, optimum gut immune responses, absence of inflammation and diseases. Gastrointestinal diseases have considerably risen over the last two decades, mainly due to increased consumption of refined and junk foods. These diseases lead to a number of other health problems and consequently increase the disease burden on our already crumbling health care system. Colorectal cancer is considered as 4th most common type of cancer. Clinical evidences have shown reduction in gastrointestinal ailments with increased consumption of whole grain cereal products. Whole grains are a good source of many dietary components which are reported to improve gastrointestinal health, including phytochemicals, resistant starches, oligosaccharides, antioxidants, vitamins, minerals and dietary fiber. Thus, the use of whole grains is suggested to address gastrointestinal problems efficiently by improving overall gut health.
Conclusively, whole grains are an excellent dietary choice to be incorporated in daily diet to avoid a number of diet linked health problems and to improve overall health status owing to their valuable nutritional profile. Most of these protective components are found in bran and germ which is lost during milling. Therefore, whole grains must be incorporated in one’s daily diet to cope with a number of non-communicable diseases. At least three servings of whole grains coupled with a diet rich in fruits & vegetables while low in refined sugar and saturated fat are recommended to maintain a good health. The optimal use of whole grains should be encouraged to derive health benefits associated with them and decrease the mortality due to diet linked disease.
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